What did the junior sister's words mean? Huang Zhilei thought about it again and again, and found that his brain might be twisted into a ball by the junior sister in a short time. After a while, sweat dripped from his forehead and asked: "Ying
Ying, why did you ask that patient to undergo an MRI before?"
This is what she said earlier.
Senior Brother Huang should have realized it by now, why would he continue to ask questions?
Dr. Song, for example, probably had insight a long time ago and asked her if she had decided on 7.2. Senior Brother Cao readily agreed to her using a ventriculoscope, knowing he would have been prepared so early.
Could it be that Senior Brother Huang didn't notice it before?
It was only after Huang Zhilei asked the question that he realized that he was the last one among the group to notice.
It is true that she mentioned the MRI as a disclaimer to the patient's family. The problem is that she deliberately mentioned the disclaimer for this kind of examination for no reason. She could only have predicted that the patient's condition really required further MRI diagnosis.
needs.
First of all, it must be affirmed that the existing examinations have clearly confirmed that the patient has non-space-occupying obstruction, and Dr. Jin’s diagnosis of communicating hydrocephalus is well-founded and basically correct.
It is not wrong to suggest that the patient undergoes medical treatment first and then undergoes surgical shunt surgery if the results are not good. After all, for communicating hydrocephalus, conventionally speaking, medical treatment and shunt surgery are the most effective. Everything is unexpected. Yes.
In some special cases of communicating hydrocephalus, other surgical methods can be used to avoid the subsequent risks and pain caused by long-term shunt placement.
This surgical method is endoscopic third ventriculostomy ETV, which has been previously performed.
Unfortunately, after explaining this to Dr. Jin, Dr. Jin then communicated with the patient’s family. Because the cost of two MRI examinations was too expensive, the patient’s family refused to let the patient have it, and they had to spend their only money on treatment costs. As a doctor
All we can do is try to find a solution for the patient.
Can ventriculoscopy be used to detect problems with the patient's ventricles?
Can you help the patient switch from shunt surgery to ETV?
Having never used a ventriculoscope before, Xie Wanying definitely did not have the confidence before the operation. She could only plan to try it based on the principles of ventriculoscope she obtained in academic journals.
Now that she has actually performed ventriculoscopy, it is expected to be feasible according to the plan she simulated before the operation, so she shared it.
After understanding her initial thoughts, Huang Zhilei started sweating again.
The main thing she said is that the magnetic resonance phase contrast cine imaging of magnetic resonance examination can accurately measure the cerebrospinal fluid flow velocity in a designated area, and establish a flow curve (flow velocity-time curve) based on this.
One of the key points of the examination and scan was to use a ventriculoscope to scan back and forth at the suspected problem area at this stage: the midbrain aqueduct area.
The cerebrospinal fluid flow rate in this place can indeed provide evidence for distinguishing communicating hydrocephalus from obstructive hydrocephalus, or it can be said to be the key point that supports whether doctors can perform ETV surgery on patients.
If there is a problem with the flow rate of the midbrain aqueduct, it means that it is most likely a trumpet-shaped midbrain aqueduct. This shape of the midbrain aqueduct is similar to obstructive hydrocephalus, and ETV surgery can be tried.
The problem was that the junior surgeon was so "whimsical" that she could use a ventriculoscope to visually detect that the abnormal flow rate of cerebrospinal fluid was within the scope of the trumpet-shaped midbrain aqueduct.
He, Huang Zhilei, really couldn't see it or calculate it, even if he had experience, he could only sweat over and over again.